Can Paramedics suffer a moral injury from simply waiting in the Hospital hallway?

1. Does Hospital Hallway Care Cause Paramedics To Suffer A Moral Injury?
Don Sharpe
Alberta Registered Paramedic
Recently I was speaking with another Paramedic about how it's possible
for us to suffer a serious moral injury by waiting in a hospital hallway.
Something you hadn’t considered previously? Reading this may help it
make sense now. http://moralinjuryproject.syr.edu/about-moral-injury/
Paramedics provide high quality care to sick and injured patients and
then transport them to Hospital. The problem? At the Hospital we are
dismissed to a hallway where our care by default becomes substandard.
Hallway Waiting forces EMS crews to stay where they don't belong,
attempting care they weren’t trained or hired for, while neglecting their
own work responding to and caring for patients outside the Hospital.
It starts right at triage, where we stand and have to 'sell' our patient to
a RN who's using a lengthy EHR system that clearly values process over
patient care. "No Beds,” the triage RN says, “Go Down the Hallway."
We deal daily with an increasingly adversarial Hospital culture that fails
to recognize the importance of EMS turnaround times, fails to get crews
back into service and refuses to make transfer of care to ER a priority.
Our 'Hospital-centric' Doctors and Senior Healthcare Administrators
continue to discount the importance of citizens who will suddenly
become EMS patients waiting for Paramedic care in the community.
Lengthening response times for critically ill patients are now a direct
result of EMS crews being out of service in the hospital hallway.
Paramedics on overtime are lined up at triage and a dozen ambulances
parked idling outside the ER for hours has become a common sight.
Occasional late calls are certainly expected in pre-hospital care but now
they’ve become routine. Paramedics are too often not getting home to
their families in a timely fashion. Our EMS leadership, who all leave for
home on time, have proven powerless to correct these problems.
Our union and professional associations, which we pay an awful lot of
money to, have refused to publicly take a stand to protect us and our
patients from the increasingly harmful practice of hallway waiting.
What is the result of this continuous assault on the defined ethical
values and respect for quality patient care, which all Paramedics hold?
It’s frustration, sadness, anger... all of which must be 'stuffed down' in
an effort to continue providing just adequate care to our patients, both
those waiting in the hallway, as well as waiting out in the community.
We are all trying to help, taking over care in the hallway - writing RLS's
- moving trucks in the Ambulance bay - rushing to clear the Hospital in
a RED ALERT – but we all know we're just shuffling the deck chairs
around on a sinking ship. We can’t Band-Aid this problem much longer.
So let's talk about this... and let's End Paramedic Hallway Waits.